Surgical adapter assembly for use with endoscope

ABSTRACT

Adapters for properly positioning a portion of a medical instrument that is positioned within an endoscope at site of interest is disclosed.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. Provisional Patent ApplicationNo. 61/258,922, filed Nov. 6, 2010, the disclosure of which isincorporated by reference in their entirety.

TECHNICAL FIELD

The present disclosure relates generally to surgical adapters forintroducing a surgical device into the body of a patient and, moreparticularly, to surgical adapters for use with delivering a surgicaldevice through an endoscope.

BACKGROUND

Endoscopic surgery allows for surgery to be performed while reducingdamage to the surrounding tissue as compared to open surgicalprocedures. An endoscope typically includes at least one working channelallowing insertion and deployment of various medical devices to thesurgical site. The endoscope also provides visualization of the surgicalsite during the procedure.

Once the desired position of the surgical site is reached, a surgicalinstrument may be inserted through the working channel and protrude fromthe distal end of the working channel at the visualized surgical site.For example, in one exemplary arrangement, a surgical cutting device isintroduced to excise tissue samples from the surgical site. Such asurgical cutting instrument generally requires connection to a handpiecethat provides rotary or reciprocative (or both) motion to the cuttingportion of the instrument. When the cutting operation is enabled, tissueis generally drawn through the mouth of the cutting instrument, severed,and removed from the surgical site.

Unfortunately, during the procedure the handpiece must be constantlycontrolled by the surgeon to control the extension of the instrumentbeyond the working channel of the endoscope. As such, the distal end ofthe surgical cutting device may move independently from the endoscope.Indeed, to control the placement of the surgical cutting device,typically a surgeon must continually manipulate both the endoscope andthe surgical cutting device, relying on the surgeon's hand-eyecoordination, to insure proper placement of the surgical cuttinginstrument, and to prevent inadvertent movement away from a selectedarea of interest or moving too deep into area, thereby causingunintended damage to surrounding tissues or structures. This constantcontrol of the instrument causes fatigue in the surgeon and makes itdifficult to hold the endoscope still while precisely controlling thesurgical cutting instrument during the procedure.

Further, during an endoscopic procedure, at times it is necessary toselectively adjust the depth of the medical device within the surgicalsite in order to precisely target a lesion for removal. To this end, thecutting element must be accurately positioned adjacent the lesion. Whileconventional endoscopes allow for insertion of a surgical cutting devicethrough the working channel, they do not provide for independentlymaintaining the position of the surgical cutting device with theendoscope.

Accordingly, a surgical adapter is needed that permit a surgical cuttingdevice to be operatively connected to an endoscope, without requiringconstant attention to fine hand-eye coordination. Further, a need existsfor a surgical adapter that facilitates adjustable and fixed positioningof the device within the patient, removal of the device from the workingchannel, and reinsertion of the device through the working channel to adesired position.

BRIEF DESCRIPTION OF THE DRAWINGS

Exemplary embodiments of the present disclosure will now by described byway of example in greater detail with reference to the attached figures,in which:

FIG. 1 is a side elevational view of an embodiment of an exemplaryendoscope;

FIG. 2A is a side elevational view of an embodiment of a trocar for usewith the endoscope of FIG. 1;

FIG. 2B is a detail view of a distal tip of the trocar of FIG. 2A;

FIG. 3 is a perspective view of an exemplary surgical cutting device;

FIG. 4 is a side elevational view of an embodiment of a surgical systemthat includes an endoscope, a trocar and surgical cutting device;

FIG. 5 is perspective view of an exemplary surgical adapter for use witha surgical system;

FIG. 6 is an exploded view of the surgical adapter of FIG. 5;

FIG. 7 is a partial side view of the surgical adapter of FIG. 5, as asurgical cutting device is being operatively connected thereto.

FIG. 8 is a partial side view of the surgical adapter of FIG. 5 with thesurgical cutting device operatively connected thereto to form a surgicalsub-assembly.

FIG. 9 is a side view of the surgical sub-assembly of FIG. 8, as thesub-assembly is being operatively connected to a first type ofendoscope.

FIG. 10 is a side view of the connected surgical sub-assembly of FIG. 8operatively connected to the endoscope shown in FIG. 9.

FIG. 11 is an enlarged view of encircled area 11 taken from FIG. 10.

FIG. 12 is a perspective view of an alternative embodiment of a surgicaladapter for use with a surgical system;

FIG. 13 is an exploded view of the surgical adapter of FIG. 12;

FIG. 14 is side view of the surgical adapter of FIG. 12 as a surgicalcutting device is being operatively connected thereto;

FIG. 15 is a side view of the surgical adapter of FIG. 12 with thesurgical cutting device operatively connected thereto to form a surgicalsub-assembly;

FIG. 16 is a side view of the surgical sub-assembly of FIG. 15 beingoperatively connected to the connected together endoscope and the trocarof FIGS. 1 and 2;

FIG. 17 if a side view of the connected surgical sub-assembly of FIG. 15operatively connected to the connected together endoscope and trocar ofFIGS. 1 and 2;

FIG. 18 is an enlarged view of encircled area 18 taken from FIG. 17;

FIG. 19 is a side view of another embodiment of a surgical systemincluding a connector adapter for use with the surgical adapter of FIG.5, an endoscope, and a surgical cutting device.

FIG. 20 is an enlarged view of encircled area 20 taken from FIG. 19.

FIG. 21 is a perspective view of the connector adapter shown in thesurgical system illustrated in FIG. 19.

FIG. 22 is a top plan perspective, as the connector adapter is beingsecured to the endoscope shown in FIG. 19.

FIG. 23 is a perspective view of a funnel attachment for use with anendoscope;

FIG. 24 is a partial perspective view of the funnel attachment of FIG.23 operatively attached to an endoscope; and

FIG. 25 is a side view of the funnel attachment of FIG. 23 attached tothe endoscope as a working channel of the surgical cutting device isbeing inserted therein.

DETAILED DESCRIPTION

Referring now to the discussion that follows and also to the drawings,illustrative approaches to the disclosed systems and methods are shownin detail. Although the drawings represent some possible approaches, thedrawings are not necessarily to scale and certain features may beexaggerated, removed, or partially sectioned to better illustrate andexplain the present disclosure. Further, the descriptions set forthherein are not intended to be exhaustive or otherwise limit or restrictthe claims to the precise forms and configurations shown in the drawingsand disclosed in the following detailed description.

Described herein are surgical systems that include surgical adapters foruse with surgical devices that may be suited for neurosurgicalapplications, including, but not limited to, the removal of spine andbrain tissue. The surgical systems of the present disclosure providesurgeons with an enhanced ability to control placement of a surgicaldevice within a surgical site so as to effectively control the extent oftissue cutting, as well as the impact on surrounding tissue duringtissue cutting procedures.

Endoscopes are used to visualize various areas of interest within apatient. Referring to FIG. 1, a first exemplary type of an endoscope 300is depicted. Endoscope 300 comprises a housing 301, an eye-piece 302, afiber optic light cable connector 304, and a shaft 306. Shaft 306 isdefined by a proximal end 308 which is disposed in and connected tohousing 301 and a distal end 310. As may be seen, distal end 310 isspaced apart from proximal end 308. Endoscope 300 is configured to allowa user to view a surgical area of interest proximate distal end 310through eye-piece 302, when distal end 310 is inserted into a surgicalsite. As is conventional in the art, shaft 306 also includes a conduit(not separately shown) for transmitting light provided via fiber opticconnector 304 to the surgical area. Shaft 306 may also include a lens(not separately shown) for magnifying and viewing the surgical area.

Eye-piece 302 is connected to housing 301. Eye-piece 302 may also beconnected to a camera with a camera connector (not shown) so that theimage generated by endoscope 300 can be viewed remotely on a displaymonitor.

To facilitate the use of endoscope 300 in surgical procedure, a trocar307 may also be provided, as best seen in FIGS. 2A and 2B. Trocar 307 isespecially useful for closed surgical procedures. Trocar 307 comprises atrocar body 314 and a trocar shaft 312. Trocar 307 is defined by aproximal end 316, with a proximal opening formed in trocar body 314, anda distal end 318 of shaft 312. Shaft 312 defines one or more channels inits interior. As shown in FIG. 2B, shaft 312 may have a plurality ofchannels, 324, 326, 328, and 330 which terminate at a tip distal face322. In one embodiment, a working channel 324 is sized to accommodate anouter cannula 444 of a surgical cutting device 440 (to be describedbelow in further detail). Channel 326 is sized to accommodate endoscopeshaft 306. Channel 328 may be configured as an irrigation channel usedto direct irrigation fluid from an irrigation conduit 320 to thesurgical site. Channel 330 may be configured as a relief channel used torelieve fluid pressure at the surgical site. During closed procedures,as irrigation fluid flows to a surgical site it can pressurize the site.

Referring to FIG. 3, an exemplary surgical cutting device 440 is shown,such as that disclosed in co-pending, and co-owned with the assignee ofthe present application, U.S. patent application Ser. No. 12/389,447,the contents of which are incorporated by reference in its entirety.Surgical cutting device 440 includes a handpiece 442 and a cuttingelement that includes an outer cannula 444 and an inner cannula (notshown). A distal end 447 of the cutting element is configured forinsertion into a patient.

In one exemplary configuration, handpiece 442 is configured with agenerally cylindrical shape. Handpiece 442 may be sized and shaped to begrasped with a single hand. Handpiece 442 also includes a lower housing450 comprising a proximal section 446 and a distal section 448. A fronthousing section 455 may be connected to a cam housing positioned indistal section 448. An upper housing 452 is also provided. The cuttingelement is mounted to upper housing 452 and may be fluidly connected toa tissue collector 458. In one exemplary arrangement, tissue collector458 may be operatively connected directly to upper housing 452.Alternatively, tissue collector 458 may be remotely connected to thecutting element by appropriate tubing. A vacuum line (not shown) may beconnected to a proximal end of tissue collector 458 to direct tissueinto the cutting element, as well as to deliver severed tissue to tissuecollector 458. A rotation dial 460 for selectively rotating the outercannula 444 with respect to handpiece 442 is also mounted to upperhousing 452.

In certain examples, tissue cutting device 440 may be combined with animaging device to define a surgical system 303 that is capable ofsimultaneously imaging and cutting a target tissue, such as tissueassociated with a patient's neurological system. Because assembly 303effectively combines both imaging and cutting operations into a single,integral device, it is particularly advantageous in performing closedprocedures where a surgical access path is created percutaneously.

Referring to FIG. 4, an exemplary surgical system 303 is depicted.Surgical system 303 comprises a surgical cutting device, such assurgical cutting device 440, trocar 307, and an endoscope, such asendoscope 300. As shown in FIG. 4, endoscope 300 is inserted throughtrocar 307 via endoscope channel 326 (best seen in FIG. 2B) such thatendoscope distal end 310 exits through, is flush with, or projects fromtrocar 307 at trocar shaft distal tip face 322. Surgical cutting device440 is connected to trocar 307 such that outer cannula 444 of thecutting element is inserted in the open proximal end 316, through trocarbody 314, and through working channel 324 of trocar shaft 312. Distalend 447 of the cutting element of surgical cutting device 440 projectsthrough and away from shaft distal end 318 of trocar 307 at trocar shaftdistal tip face 322.

Although various configurations are possible, in surgical system 303 ofFIG. 4, tissue cutting device 440 is positioned with a proximal portionof outer cannula 444 adjacent to endoscope housing 301. Proximal end 319of endoscope housing 301 is positioned distally of and adjacent to fronthousing 455 of surgical cutting device handpiece 442.

To use surgical assembly 303, a surgical access path is first createdand/or the target tissue is accessed using an open procedure or a closedprocedure. However, surgical assembly 303 is especially suited forclosed procedures. In one exemplary example, the surgeon places one eyeat eye-piece 302 and manipulates trocar shaft 312 to position distaltrocar tip 318 proximate the target tissue. In another exemplaryexample, a camera is attached to eye-piece 302 and the surgeon views animage on a monitor that is connected to the camera. A vacuum level to beapplied to device 440 is then set using panel controls on an attachedsurgical console. In one method, device 440 is configured to be grippedwith a single hand so as to allow simultaneous manipulation of endoscope300, trocar 307, and surgical cutting device 440. A variety of differentgrips may be used. In one example, surgical cutting device 440 is heldlike a writing instrument, with distal housing section 448 placedbetween the thumb and forefinger of one hand and proximal housingsection 446 placed between the base of the forefinger and the base ofthe thumb. In another example, the thumb is placed on one side of distalhousing section 448 and the forefinger is placed on top of upper housing452 with proximal housing section 446 between the base of the thumb andforefinger. In yet another example, the proximal housing section 446 isgripped with the thumb placed adjacent proximal-most housing portion442.

Depending on the selected hand and the surgeon's position with respectto that of the target tissue, dial 460 may be rotated to selectivelyrotate outer cannula 444 about its own longitudinal axis and to orientan outer cannula opening 449 immediately adjacent the target tissue.Surgical cutting device 440 is preferably configured such that whenouter cannula 444 rotates, an inner cannula also rotates to maintain afixed angular orientation between outer cannula 444 and the innercannula. Once outer cannula opening 449 is in the desired position, amotor of surgical cutting device 440 is activated. In one example, thesurgeon views the target tissue through eyepiece 302 to visualize thetissue's response (e.g., traction) to various levels of vacuum andselects a desired level.

Due to the application of vacuum, the target tissue proximate trocardistal end 318 is drawn into outer cannula opening 449. If desired, anirrigation fluid such as saline may be fed to the target tissue area viairrigation conduit 320 (shown in FIG. 2B).

Endoscope 300 is configured to allow a surgeon to view the target tissuethrough eye-piece 302. However, as discussed above, a camera may also beconnected to a camera connector (not shown) attached to eyepiece 302allowing the image generated by endoscope 300 to be viewed on a displaymonitor. In accordance with one example, the surgeon views the targettissue on the display monitor while manipulating surgical system 303 andcutting tissue.

In certain examples, surgical device 440 is configured such that itsouter cannula 444 can be accommodated by working channels in known,industry standard sized trocars. For example, in certain embodiments,working channel 324 has an inner diameter of less than 8 mm, preferablyless than 6 mm, more preferably less than 4 mm, and most preferablyabout 2 mm. However, it is understood that there may be other deicesthat include working channels 324 having an inner diameter even lessthan 2 mm. Outer cannula 444 is also configured with an outer diameterthat allows outer cannula 444 to be slidably received in working channel324. In other examples, outer cannula 444 is at least as long as knownworking channels. In certain embodiments, outer cannula 444 is at leastabout 6 inches, preferably at least about 8 inches, more preferably atleast about 10 inches, and even more preferably at least about 12 inchesin length.

Surgical assembly 303 is useful in a number of procedures, but isespecially beneficial in closed procedures. In one exemplary method,surgical assembly 303 is used to perform closed, percutaneous tissuecutting procedures in the third ventricle of the brain. Such proceduresinclude removing tumors and membranes in the third ventricle. Inaddition, cerebrospinal fluid circulates through the third ventricle andinto the spinal column. In certain patients, occlusions can form in thethird ventricle, blocking the fluid circulation. Surgical assembly 303may be used to remove such occlusions and restore circulation. Otherclosed procedures for which surgical assembly is particularly wellsuited include the removal of tumors from the hypothalamus.

While surgical system 303 of FIG. 4 represents an advancement insurgical devices and procedures, there is no mechanism that suitablysecures surgical cutting device 440 to endoscope 300. As such, distalend 447 of surgical cutting device 440 may move independently from shaft312 of trocar 307. Accordingly, the surgeon must be sure to manipulateboth trocar 307 and surgical cutting device 40 to insure properplacement of distal end 447 of surgical cutting device 440 to preventdistal end 447 from inadvertently moving away from an area of interestor moving too deep into the area of interest causing unintended damageto surrounding tissues and structures.

Specifically referring to FIGS. 5-12, to operatively connect surgicalcutting device 440 to an alternative endoscope 350 configuration, afirst exemplary embodiment of a surgical adapter 500 is provided.Surgical adapter 500 comprises a connecting portion 502, a housingportion 504 and an attachment mechanism 506. In one exemplaryembodiment, housing portion 504 may be constructed of a first portion504 a and a second portion 504 b that fit together, such as in asnap-fit arrangement. Housing portion 504 may house an advancingmechanism 508, a gear member 509 and a thrust washer or spring member510. A dial member 512 is partially received within housing portion 504and rotatably mounted thereto. A shaft member 514 is partially receivedwithin a distal end 516 of housing portion 504.

Gear member 409 is rotatably mounted within housing portion 504 andincludes gear teeth 518 that mesh with gear teeth 520 mounted on dialmember 512. A channel 522 is formed through gear member 509. A proximalend 524 of advancing mechanism 508 is fixedly received within channel522. Advancing mechanism 508 further includes threads 526 formed on anouter surface thereof, and a receiving channel 528, both of which willbe explained below in further detail.

A proximal end 530 of attachment mechanism 506 is secured to a distalend 532 of shaft member 514. Shaft member 514 further comprises at leastone slot member 534 into which a tab member 536 (seen, for example,mounted on first portion 504 a) from housing portion 504 is slidablyreceived. In another exemplary configuration, shaft member 514 maycomprise more than slot member 534 that mate with a plurality ofcorresponding tab members 536. In one exemplar configuration, tabmembers 536 are arranged in an opposing manner within housing portion504. It is understood that various locations for tab members 536 onhousing portion 504 are contemplated. It is also understood that otherconfigurations for keying shaft member 514 to housing 504 are alsocontemplated.

Threads 526 operatively engage with threads formed on an internalsurface of shaft member 514, to be explained in further detail below.Attachment mechanism 506 further includes a shaft member 538 and a capmember 540. Shaft member 538 defines a passageway 539 therethrough.

Referring now to FIGS. 7-11, use of surgical adapter 500 will now beexplained. First, distal end 447 (best seen in FIG. 3) of surgicalcutting device 440 is inserted into surgical adapter 500. Morespecifically, distal end 447 of the cutting element of surgical cuttingdevice 440 is inserted into a top portion 542 of connecting portion 502and into receiving channel 528 of advancing mechanism and advancedthrough attachment mechanism 506. Top portion 542 further includes amounting groove that receives a distal end 462 of upper housing 452 forfrictional engagement. A bottom portion 444 of connecting portion 502also includes a mounting groove that receives distal end 451 of lowerhousing 450 for frictional engagement, as shown in FIG. 8. In oneexemplary embodiment, assembly of surgical adapter 500 to surgicalcutting device 440 is performed at the factory prior to packaging anddelivery of the devices. Further, to provide increased stability to thesurgical system, distal end 451 may be fixedly connected to the mountinggroove.

Once secured, distal end 447 of the cutting element of surgical cuttingdevice 440 is then received in a proximal end 446′ of an endoscope 300′.In one embodiment attachment mechanism 506 fixedly engages a portion 447of endoscope 300′, thereby securing tissue cutting device 440 toendoscope 300′. More specifically, attachment mechanism 506 is disposedaround proximal end 446′ such that proximal end 446′ is received withinendoscope receiving portion 540. Mounting groove member 538 is receivedwithin portion 447 of endoscope 300′.

However, in accordance with one aspect of the disclosure, the extentthat distal end 447 may extend outwardly from a distal end of endoscope300′ may be selectively controlled by the surgeon. More specifically,dial member 512 may be selectively rotated in a first direction toadvance distal end 447 of the cutting element of surgical cutting device440 with respect to the distal end of endoscope 300′. Dial member 512may be selectively rotated in a second direction to move distal end 447of surgical cutting device 440 toward proximal end 446′ of endoscope300′.

Gear teeth 520 of dial member 512 mesh with gear teeth 518 of gearmember 509 such that when dial member 512 is rotated, gear member 509also rotates. Because proximal end 524 of advancing mechanism 508 isfixedly secured to gear member 509, as gear member 509 rotates,advancing mechanism 508 also rotates. Receiving channel 528 is sized toreceive outer cannula 444. Thus rotation of advancing mechanism 508causes shaft member 514 to move along tab member 536, effectively movingdistal end 447 of the cutting element.

Because surgical adapter 500 secures surgical cutting device 440 toendoscope 300′, the surgeon may better control the amount of extent ofdistal end 447 of outer cannula 444 to allow for safer, more secure,more stable and a more accurate placement of the cutting mechanism.

Referring to FIGS. 12-18, an alternative embodiment of a surgicaladapter 600 is shown. Surgical adapter 600 is similar to surgicaladapter 500 in that it comprises a connecting portion 602, a housingportion 604 and an attachment mechanism 606. In one exemplaryembodiment, housing portion 604 is constructed of a first portion 604 aand a second portion 604 b that matingly fit together, such as in asnap-fit arrangement. Housing portion 604 may house an advancingmechanism 608, a gear member 609 and a wave washer or spring member 610.A dial member 612 is partially received within housing portion 604 androtatably mounted thereto. A shaft member 614 is partially receivedwithin a distal end 616 of housing portion 604, similar to that whichwas described above in connection with surgical adapter 500.

Gear member 609 is rotatably mounted within housing portion 604 andincludes gear teeth 618 that mesh with gear teeth 620 mounted on dialmember 612. A channel 622 is formed through gear member 609. A proximalend 624 of advancing mechanism 608 is fixedly received within channel622. Advancing mechanism 608 further includes threads 626 formed on anouter surface thereof, and a receiving channel 628, both of which willbe explained below in further detail.

Attachment mechanism 606 is secured to a distal end of shaft member 614.Shaft member 614 further comprises at least one slot member 634 intowhich a tab member 636 from housing portion 604 is slidably received.Threads 626 operatively engage with threads formed on an internalsurface of shaft member 614, to be explained in further detail below.Attachment mechanism 606 includes a mounting groove member 638 having acannula receiving portion 639 and an endoscope receiving portion 640. Aretaining member 641 is selectively engageable with attachment mechanism606, to be explained below in further detail. A locking washer 643 mayalso be included.

Referring now to FIGS. 14-18, use of surgical adapter 600 will now beexplained. First, distal end 447 (best seen in FIG. 3) of surgicalcutting device 440 is inserted into surgical adapter 600. Morespecifically, distal end 447 of the cutting element of surgical cuttingdevice 440 is inserted into a top portion 642 of connecting portion 602and into receiving channel 628 and advanced through cannula receivingportion 639 of attachment mechanism 606. Top portion 642 includes amounting groove that receives distal end 462 of upper housing 452 forfrictional engagement. A bottom portion 644 of connecting portion 602also includes a mounting groove that receives a distal end 451 of lowerhousing 450 for frictional engagement, as shown in FIG. 15. In oneexemplary embodiment, assembly of surgical adapter 600 to surgicalcutting device 440 is performed at the factory prior to packaging anddelivery of the devices.

Once secured, distal end 447 of outer cannula 44 (and inner cannulapositioned therein) is then received in proximal end 316 of trocar 307.In one embodiment attachment mechanism 606 fixedly engages a portion ofendoscope 300, thereby securing surgical cutting device 440 to endoscope300. More specifically, endoscope receiving portion 640 is sized toengage an outer surface of endoscope 300, leaving cannula receivingportion 639 open, but in general alignment with working channel 324.Once properly positioned, fastening mechanism 641 is actuated tofrictionally attach attachment mechanism 606 to endoscope 300. Endoscope300 is also attached to trocar 307, as described above. Thus, tissuecutting device 40 is also fixed with respect to trocar 307.

However, in accordance with one aspect of the disclosure, the extentthat distal end 447 may extend outwardly from distal end face 322 oftrocar 307 may be selectively controlled by the surgeon. Morespecifically, dial member 612 may be selectively rotated in a firstdirection to advance distal end 447 of outer cannula 444 of tissuecutting device 440 with respect to distal end face 322 of trocar 307.Dial member 612 may be selectively rotated in a second direction to movedistal end 447 of outer cannula 444 toward trocar 307.

Gear teeth 620 of dial member 612 mesh with gear teeth 618 such thatwhen dial member 612 is rotated gear mechanism 609 rotates. Becauseproximal end 624 of advancing mechanism 608 is fixedly secured to gearmechanism 609, as gear mechanism 609 rotates, advancing mechanism 608also rotates. Receiving channel 628 is sized to receive outer cannula444. Thus rotation of advancing mechanism 608 causes shaft member 614 tomove along tab member 636, effectively moving distal end 447 of outercannula 444.

Because surgical adapter 600 secures surgical cutting device 440 toendoscope 300, the surgeon may better control the amount of extent ofdistal end 447 of outer cannula 444 to allow for safer, more secure,more stable and more accurate placement of the cutting mechanism.

Referring to FIGS. 19-22, a surgical system 800 is depicted. Surgicalsystem 800 comprises an endoscope 300″, a surgical adapter 500 and aconnector adapter 700. In one exemplary arrangement, endoscope 300″ is aLOTTA® style endoscope distributed by the Karl Storz Endoscopy-America,Inc., El Segundo, Calif., and further includes a proximal end 446″.

Connector adapter 700 comprises a shaft member 702, a proximal mountingmember 704, a support member 706 and selectively engageable connectingmembers 708. A seal member 709 (best seen in FIG. 22) is secured tosupport member 706. Each connecting member 708 is operatively secured tosupport member 706 by a living hinge 710.

Connector adapter 700 provides a user with the ability to utilize avariety of instrumentation with endoscope 300″, without requiring anypermanent modifications to endoscope 300″ or to the instrumentation by auser in the field, or by the manufacturer of endoscope 300″. Moreover,connector adapter 700 is configured to provide a selectively attachablesealed interface between a working channel of endoscope 300″ and asurgical instrument such as, for example, the NICO MYRIAD® manufacturedand distributed by Nico Corporation of Indianapolis, Ind.

More specifically, shaft member 702 is fixedly mounted to support member706. A working channel 712 extends through support member 706 and shaftmember 702. Mounting member 704 may be secured to a proximal end ofshaft member 702. In one exemplary configuration, mounting member 704 isconfigured as a flange member. However, it is understood that othermounting elements may also be provided including, but not limited to,threaded engagements.

As discussed above, connector adapter 700 further includes connectingmembers 708. In one exemplary arrangement, connecting members 708 arearranged in an opposing manner, as shown in FIG. 21. In one exemplaryarrangement, connecting adapter 700 includes at least two connectingmembers 708 a, and 708 b. First connecting member 708 a is configuredwith at least one selectively depressible locking tab 714. Secondconnecting member 708 b is configured with a corresponding number ofreceiving grooves 716. Locking tabs 714 are configured to be selectivelyreceived and retained within corresponding receiving grooves 716 whenconnector adapter 700 is mounted to a surgical system, as will beexplained in further detail below.

In operation, surgical adapter 500 is attached to a surgical cuttinginstrument such as that discussed above in connection with FIG. 3.Mounting member 704 of connector adapter 700 is then connected to capmember 540 of surgical adapter 500 such that shaft member 538 (best seenin FIG. 6 above) is received within working channel 712. Mounting member704 is configured to engage with a corresponding mounting feature formedin cap member 540. For example, an internal surface of cap member 540may be configured with frictional members that secure mounting portion704 therein. Alternatively, as discussed above, both cap member 540 andmounting portion 704 may be provided with corresponding threads suchthat a threaded attachment may be achieved.

Once mounting portion 704 is secured to surgical adapter 500, connectoradapter 700 is brought into engagement with a proximal end 446″ ofendoscope 300″ such that seal member 709 engages proximal end 446″. Sealmember 709 is also configured with an opening therethrough (not shown)that is axially aligned with working channel 712 of shaft member 702.Seal member 709, which is constructed of a suitable sealing material toachieve a fluid-tight seal, is also configured so as to have acircumference that is at least as large as a circumference of anentrance piece to proximal end 446″ of endoscope 300″.

When seal member 709 is initially brought into engagement with proximalend 446″ of endoscope 300″, first and second connecting member 708 a and708 b oriented toward support member 706 such that connecting members708 a, 708 b are separated form one another, as shown in FIGS. 21 and22. In other words, first and second connecting members 708 a and 708 bpivoted about living hinges 710.

In one exemplary configuration, first and second connecting members 708a, 708 b are each configured with a mount surface 718 that mates withseal member 709 when first and second connecting members 708 a, 708 bare in a connected position (as shown in FIGS. 19-20). Connectingmembers 708 a, 708 b each may also be provided with an angled contactingface 720 that extends from living hinge 710 to an outer surface 722 ofeach connecting member 708 a, 708 b. Angled contacting face 720 isconfigured with cooperate with a corresponding angled contacting face724 disposed on either side of support member 706.

Once seal member 709 engaged with proximal end 446″ of endoscope 300″,connecting members 708 a, 708 b are then pivoted toward one another soas to surround and mate to proximal end 446″ of endoscope 300″. Lockingtabs 714 are then engaged with receiving grooves 716 so as to lockconnecting members 708 a, 708 b quickly and easily together, therebysecuring connector adapter 700 onto endoscope 300″. Once the medicalprocedure is completed, connector adapter 700 may be selectivelydetached from endoscope 300″ by simply depressing a portion of lockingtabs 714 that is disposed externally from an outer surface 726 ofconnector adapter 700 (best seen in FIG. 20) to release locking tabs 714form retaining grooves 716.

Referring to FIGS. 23 and 24, a funnel attachment 900 designed to directdistal end 447 of a cutting element from a surgical cutting instrument,such as cutting instrument 440, into a working channel 328 of trocar 307is shown. During a surgical procedure, when a distal end of trocar 307is positioned within a patient, the surgeon is viewing the surgicalfield, either through eyepiece 302 or on a display monitor. Thus, whilethe surgeon is viewing the surgical area, the surgeon may also be tryingto insert distal end 447 into working channel 328 blindly. This approachoften results in multiple frustrating attempts at trying to locate theopening of working channel 328 for receiving the outer cannula or othersurgical component, and cause the loss of efficiency and valuableoperating time.

To address this concern, funnel attachment 900 is provided. Funnelattachment 900 comprises a directing portion 902 and leg members 904.Leg members 904 are configured to fit over a housing 301 of an endoscope300 and abut up against a proximal end of trocar 307. Feet members 906extending from leg members 904 engage a bottom surface of housing 301 tosecure funnel attachment 900 thereto.

Funnel attachment 900 is further defined by a proximal side 908 and adistal side 910. Directing portion 902 is defined by a funnel-likesurface 912 that tapers toward a directing groove 914. When funnelattachment 900 is secured to endoscope 300, directing portion 902 ispositioned such that directing groove 914 generally aligns with workingchannel 328 of trocar 307. Thus, as the surgeon is viewing the surgicalarea, the funnel-like surface 912 will serve to direct distal end 447 ofan outer cannula 44 of a surgical cutting instrument 440 into directinggroove 914, resulting in outer cannula 444 being correctly placed withinworking channel 328.

While funnel attachment 900 is not shown in use with surgical adapters500, 600 or connector adapter 700, it is understood that funnelattachment 900 may be used with all of these components.

It will be appreciated that the devices and methods described hereinhave broad applications. The foregoing embodiments were chosen anddescribed in order to illustrate principles of the methods andapparatuses as well as some practical applications. The precedingdescription enables others skilled in the art to utilize methods andapparatuses in various embodiments and with various modifications as aresuited to the particular use contemplated. In accordance with theprovisions of the patent statutes, the principles and modes of operationof this invention have been explained and illustrated in exemplaryembodiments.

It is intended that the scope of the present methods and apparatuses bedefined by the following claims. However, it must be understood thatthis invention may be practiced otherwise than is specifically explainedand illustrated without departing from its spirit or scope. It should beunderstood by those skilled in the art that various alternatives to theembodiments described herein may be employed in practicing the claimswithout departing from the spirit and scope as defined in the followingclaims. The scope of the invention should be determined, not withreference to the above description, but should instead be determinedwith reference to the appended claims, along with the full scope ofequivalents to which such claims are entitled. It is anticipated andintended that future developments will occur in the arts discussedherein, and that the disclosed systems and methods will be incorporatedinto such future examples. Furthermore, all terms used in the claims areintended to be given their broadest reasonable constructions and theirordinary meanings as understood by those skilled in the art unless anexplicit indication to the contrary is made herein. In particular, useof the singular articles such as “a,” “the,” “said,” etc. should be readto recite one or more of the indicated elements unless a claim recitesan explicit limitation to the contrary. It is intended that thefollowing claims define the scope of the invention and that the methodand apparatus within the scope of these claims and their equivalents becovered thereby. In sum, it should be understood that the invention iscapable of modification and variation and is limited only by thefollowing claims.

1-20. (canceled)
 21. A selectively removable connector adapter for usein connecting a medical device to an endoscope, the connector adaptercomprising: a shaft member defined by a proximal end and a distal endand having a passageway extending therethrough and configured forreceiving a portion of a medical device; a support member; and at leasttwo connecting members that are pivotally connected to the supportmember; wherein the distal end of the shaft member is fixedly attachedto the support member; and wherein the connecting members cooperate todefine a cavity therein for receiving a proximal portion of an endoscopeto selectively secure the connector adapter to the endoscope.
 22. Theconnector adapter of claim 21, wherein the connecting members are eachpivotally attached to the support member by a living hinge disposedalong a lateral edge of the support member.
 23. The connector adapter ofclaim 22, wherein one of the connecting members includes at least onelocking tab and the other of the connecting members includes at leastone corresponding retaining groove, wherein the locking tab isconfigured to be selectively received and retained within thecorresponding receiving groove to secure the connector adapter to aportion of the proximal end of an endoscope.
 24. The connector adapterof claim 22, wherein each connecting member further includes a mountsurface that is disposed adjacent a distal side of the support member,when the connecting members are pivoted toward one another.
 25. Theconnector adapter of claim 24, wherein each connecting member furthercomprises a contacting face that each may engage with a correspondingcontacting face that is disposed on edges of the support member,adjacent the living hinges.
 26. The connector adapter of claim 25,wherein each contacting face of the connecting members are angled. 27.The connector adapter of claim 26, wherein each contacting face of thesupport member is angled.
 28. The connector adapter of claim 21, furthercomprising a seal member disposed adjacent a distal side of the supportmember.
 29. A selectively removable connector adapter for use inconnecting a medical device to an endoscope, the connector adaptercomprising: a shaft member defined by a proximal end and a distal endand having a passageway extending therethrough and configured forreceiving a portion of a medical device; a support member; a seal memberdisposed adjacent a distal side of the support member; and at least twoconnecting members that are pivotally connected to the support by aliving hinge disposed along a lateral edge of the support member;wherein the distal end of the shaft member is fixedly attached to thesupport member; and wherein the connecting members cooperate to define acavity therein for receiving a proximal portion of an endoscope toselectively secure the connector adapter to the endoscope.
 30. Theconnector adapter of claim 29, wherein one of the connecting membersincludes at least one locking tab and the other of the connectingmembers includes at least one corresponding retaining groove, whereinthe locking tab is configured to be selectively received and retainedwithin the corresponding receiving groove to secure the connectoradapter to a portion of the proximal end of an endoscope.
 31. Theconnector adapter of claim 30, wherein each connecting member furtherincludes a mount surface that is disposed adjacent a distal side of thesupport member, when the connecting members are pivoted toward oneanother.
 32. The connector adapter of claim 29, wherein each connectingmember further comprises a contacting face that each may engage with acorresponding contacting face that is disposed on edges of the supportmember, adjacent the living hinges.
 33. The connector adapter of claim32, wherein each contacting face of the connecting members are angled.34. The connector adapter of claim 33, wherein each contacting face ofthe support member is angled.